COMPARISON OF EFFICACY OF ORAL AND INTRAMUSCULAR IRON SUPPLEMENTATION FOR TREATMENT OF IRON DEFICIENCY ANEMIA IN CHILDREN

Oral and Intramuscular Iron Supplementation

Abstract

Objective: To compare the efficacy of oral iron preparation with intramuscular iron sorbitol in treatment of iron deficiency anemia in children.

Study Design: Randomized controlled trial.

Place and Duration of Study: Paediatric department of Combined Military Hospital Kharian, Pakistan, from October 2011 to March 2013.

Patients and Methods:  In total 200 anemic children from 6 months to 5 years of age were included. Cut off value for Hb was < 8 gm/dl. Patients were divided into two groups, each of 100, randomly. Group A received oral sodium feredetate (iron edetate) and group B received intramuscular iron sorbitol.  Rise in Hb > 10 gm/dl was kept as the desired value. Maximum duration of treatment planned was 12 weeks for group A and 2 weeks for group B. Laboratory parameters such as Hb%, mean corpuscular volume (MCV), retic count and serum ferritin level were used to detect the responses in both groups at one week, two weeks, four weeks and twelve weeks of treatment.

Results: Among 200 patients, male and female distribution was 45% and 55% respectively.. Desired rise in Hb in group B was achieved much earlier i.e. at two weeks as compared to group A.  Progressive rise in laboratory parameters was observed but this rise was more evident in group B as compared to group A. After one week treatment in group A, rise in retic count, Hb, ferritin and MCV was 0.759 ± 0.318, 0.814 ± 0.387, 0.47 ± 0.154 and 4.28 ± 2.468 respectively. But rise in these values in group B was 2.235±0.632, 2.335 ± 0.135, 6.31 ± 1.123 and 12.11 ± 0.414 respectively. Same persistent different trend was observed at 2 and 4 weeks. After 12 weeks treatment in group A, rise in retic count, Hb, ferritin and MCV was 1.044 ± 0.222, 5.204 ± 0.134, 17.39 ± 2.551 and 16.61 ± 1.214 respectively but rise in these laboratory indices in group B was 0.551 ± 0.261, 6.097 ± 0.21, 42.49 ± 2.768 and 20.68 ± 2.233 respectively. The comparison of hematological indices after 12 weeks in A and B groups show significant differences. All these parameters improved in both groups but improvement in group B was drastically more prominent when compared with group A (p-value < 0.05).

Conclusion: Intramuscular iron sorbitol therapy is an alternative and comparatively better treatment option as compared to oral iron therapy, sodium feredetate, in regards of treatment duration and earlier rise in the laboratory indices.